Threats from all sides

Recently someone recommended that I do a SWOT. A WHAT? A SWOT. In other words, an analysis of my practice's Strengths Weaknesses Opportunities and Threats, ie SWOT. I enjoyed doing the S and O portions of the SWOT, but the T was very disturbing, both in raw number and in ratio form with the O. In other words, my T/O ratio appears out of whack. Not good.

My threats include:

• rising insurance costs
• rising rent
• rising payroll
• rising administrative costs
• increasing oversight
• increasing regulation
• declining reimbursements
• litigation threats

Then yesterday, KevinMD ran a link the following post: http://www.emrupdate.com/forums/p/10746/72642.aspx#72642

Damn! I guess I now need to add that to my SWOT list. What if I just bought product A then United Health Care demands I buy product B, then Blue Cross demands I buy product C? Then what? Sheer craziness. I suppose it is legal for them to do that, but it strikes me as problematic.
In any case, I'll add it to the T's, which now vastly outweigh the O's.

Most of my threats are similar to threats to other doctors. Some may find some perverse comfort in the fact that we are all on a sinking ship together, but not me. I believe that when the bow of the ship goes under water, and the stern rises into the air, it'll be every man for himself. And it won't be a pretty picture.

Threats from all sides. How will it end. . .?